1.Bone remodeling in the Masquelet-induced membrane model of rat femur by modulation of H-type vessels by total flavonoids of rhizome drynariae
Zhikui ZENG ; Wei XIONG ; Weidong LIANG ; Guowen QIAN ; Chaoyi LIANG ; Bin PAN ; Ling GUO ; Wenqiang WEI ; Xunxiang QIU ; Wenfang DENG ; Lingmei YUAN
Chinese Journal of Tissue Engineering Research 2024;28(32):5130-5135
BACKGROUND:Several studies have found that the total flavonoids of rhizome drynariae can promote neovascularization in the induced membrane,improve the biological properties of the induced membrane,and accelerate bone remodeling in the induced membrane,but the related molecular mechanisms still need to be further explored. OBJECTIVE:To explore the effect of total flavonoids of rhizome drynariae on bone remodeling in rat femoral Masquelet-induced membrane model by regulating H-type blood vessels. METHODS:Thirty-six male Sprague-Dawley rats were stratified by body mass and then randomly divided into blank group,model group and traditional Chinese medicine group,with 12 rats in each group.A 4-mm femoral bone defect model was established in all the rats.Bone defects in the model group and traditional Chinese medicine group were filled with polymethylmethacrylate bone cement.At 6 weeks after modeling,the tail bone of the rats was implanted in the blank group,as well as in the other two groups after removal of bone cement.The traditional Chinese medicine group was given 157.5 mg/kg per day of total flavonoids of rhizome drynariae at 3 days after bone implantation,while the model and blank groups were given the same amount of saline by gavage until the 8th week after bone implantation.Bone graft samples were taken for relevant testing at 8 weeks after implantation. RESULTS AND CONCLUSION:X-ray films showed that in the blank group,the fracture line in the defect area was clear,and only a small amount of bone callus formed;in the model group,the bone defect area still existed,where discontinuous cortical bone was visible;in the traditional Chinese medicine group,the defect area was filled with newborn bone tissues,the bone marrow cavity and part of the cortical bone formed,and the fracture line disappeared.Micro-CT scans showed that the amount of new bone in the defect area was low in the blank group,the number of bone trabeculae in the defect area was significantly increased in the model group,and a large amount of new bone tissue was filled in the bone defect area in the traditional Chinese medicine group.Hematoxylin-eosin staining results showed that in the blank group,only a small amount of new bone formed in the defect area and the quality of osteogenesis was poor;in the model group,there was more new bone tissue in the defect area,but some fibrous connective tissues were interspersed within the bone tissue;and in the traditional Chinese medicine group,a large amount of new bone formed in the defect area and the quality of osteogenesis was the best.CD31/Emcn immunofluorescence double-labeling staining results showed that the number of H-type blood vessels in the newborn bone tissue in the bone defect area of the blank group was sparse and sparsely distributed;compared with the blank group,there were more H-type blood vessels in the bone tissue in the bone defect area of the model group,and the blood vessels were distributed in relatively regular strips;the number of H-type blood vessels in the bone defect area of the traditional Chinese medicine group was the highest and the blood vessels were densely distributed.To conclude,the total flavonoids of rhizoma drynariae can upregulate the expression of H-type blood vessels to enhance the angiogenic-osteogenic effect,improve the osteogenic efficiency of the rat femoral Masquelet induced membrane model,and promote bone remodeling.
2.Sentinel surveillance data of influenza in Hunan Province from 2014 to 2023
Xiao-Lei WANG ; Chao-Yang HUANG ; Qian-Lai SUN ; Zhi-Hong DENG ; Yi-Wei HUANG ; Shan-Lu ZHAO ; Kai-Wei LUO ; Xiang REN ; Sheng-Bao CHEN ; Zhi-Hui DAI
Chinese Journal of Infection Control 2024;23(11):1413-1420
Objective To understand the prevalence characteristics of influenza and changes of influenza virus strains,and provide reference for the prevention and control of influenza in the province.Methods Surveillance da-ta about influenza in Hunan Province from 2014 to 2023 were exported from China Influenza Surveillance Informa-tion System.Differences in the percentage of influenza-like illness(ILI)cases(percentage of influenza-like cases[ILI%]in outpatient and emergency department visits)among different years and different populations,as well as the positive rate of influenza virus in ILI specimens were compared.Results From 2014 to 2023,over 2.65 million cases of ILI were reported,with an ILI%of 4.70%.ILI%among different years presented statistically significant differences(P<0.001).People aged 0-14 years old were the main population with ILI,accounting for 82.90%.The positive rate of influenza virus in ILI specimens was 14.14%,the positive rate of influenza virus among diffe-rent years and age groups were both significantly different(both P<0.001).The main prevalent influenza strains from 2014 to 2023 included types A(H1N1),A(H3N2),B(Victoria),and B(Yamagata),alternating among di-fferent years.However,type B(Yamagata)strains were not detected from 2020 to 2023.There were basically two influenza prevalence seasons every year,namely winter-spring and summer.Conclusion People<15 years old are the main population of influenza,and the prevalence peaks are in winter-spring and summer.From 2021 to 2023,the prevalence alternates mainly among 3 types:A(H1N1),A(H3N2),and B(Victoria).
3.Cardiac Magnetic Resonance Tissue Tracking Technology in Biventricular Function Assessment of Patients with Chronic Kidney Disease
Shutian AN ; Wei DENG ; Hao QIAN ; Caiyun HAN ; Ren ZHAO ; Yongqiang YU ; Xiaohu LI
Chinese Journal of Medical Imaging 2024;32(11):1123-1128
Purpose To explore the changes in biventricular volume and mass in chronic kidney disease(CKD)patients with preserved ejection fraction using cardiac magnetic resonance(CMR),and evaluate cardiac function using tissue-tracking strain analysis.Materials and Methods The retrospective analysis of 40 CKD patients without symptoms of cardiovascular disease,diabetes and the estimated glomerular filtration rate<60 ml/(min·1.73 m2)who were treated at the First Affiliated Hospital of Anhui Medical University from October 2020 to June 2023 and 25 age-and gender-matched healthy volunteers.All participants underwent 1.5T CMR scans to calculate left and right ventricular function,myocardial strain and native T1 and T2 values,and differences in various imaging parameters between the two groups were compared.Results The native T1 value[(1 109.6±35.9)ms]and T2 value[(58.1±2.9)ms]of CKD patients were significantly higher than those in control group[(1 046.3±15.9)ms,(53.3±2.3)ms](t=8.296,6.916,both P<0.001).The left ventricular end-diastolic volume index,left ventricular end-systolic volume index,left ventricular mass index,right ventricular end-diastolic volume index,right ventricular end-systolic volume index and right ventricular mass index of CKD patients were significantly increased compared with the control group(t=3.233,3.350,5.751,7.746,5.937,2.363,all P<0.05),while the left and right ventricular strain parameters,left ventricular global longitudinal strain,left ventricular global circumferential strain,left ventricular global radial strain,right ventricular global longitudinal strain,right ventricular global circumferential strain and right ventricular global radial strain were significantly decreased(t=9.506,9.072,-10.603,10.496,11.574,-4.018,all P<0.001),and the estimated glomerular filtration rate exhibited significant correlations with left ventricular global longitudinal strain(r=-0.636),left ventricular global radial strain(r=0.688),right ventricular global longitudinal strain(r=-0.513),right ventricular global circumferential strain(r=-0.827)and right ventricular global radial strain(r=0.514)(all P<0.001).Conclusion CMR can quantitatively assess myocardial fibrosis and edema in patients with CKD,and tissue tracking strain analysis can detect myocardial motion abnormalities before changes in ventricular ejection fraction,offering value in the early detection of cardiac involvement in CKD patients..
4.Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients (version 2024)
Yao LU ; Yang LI ; Leiying ZHANG ; Hao TANG ; Huidan JING ; Yaoli WANG ; Xiangzhi JIA ; Li BA ; Maohong BIAN ; Dan CAI ; Hui CAI ; Xiaohong CAI ; Zhanshan ZHA ; Bingyu CHEN ; Daqing CHEN ; Feng CHEN ; Guoan CHEN ; Haiming CHEN ; Jing CHEN ; Min CHEN ; Qing CHEN ; Shu CHEN ; Xi CHEN ; Jinfeng CHENG ; Xiaoling CHU ; Hongwang CUI ; Xin CUI ; Zhen DA ; Ying DAI ; Surong DENG ; Weiqun DONG ; Weimin FAN ; Ke FENG ; Danhui FU ; Yongshui FU ; Qi FU ; Xuemei FU ; Jia GAN ; Xinyu GAN ; Wei GAO ; Huaizheng GONG ; Rong GUI ; Geng GUO ; Ning HAN ; Yiwen HAO ; Wubing HE ; Qiang HONG ; Ruiqin HOU ; Wei HOU ; Jie HU ; Peiyang HU ; Xi HU ; Xiaoyu HU ; Guangbin HUANG ; Jie HUANG ; Xiangyan HUANG ; Yuanshuai HUANG ; Shouyong HUN ; Xuebing JIANG ; Ping JIN ; Dong LAI ; Aiping LE ; Hongmei LI ; Bijuan LI ; Cuiying LI ; Daihong LI ; Haihong LI ; He LI ; Hui LI ; Jianping LI ; Ning LI ; Xiying LI ; Xiangmin LI ; Xiaofei LI ; Xiaojuan LI ; Zhiqiang LI ; Zhongjun LI ; Zunyan LI ; Huaqin LIANG ; Xiaohua LIANG ; Dongfa LIAO ; Qun LIAO ; Yan LIAO ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Peixian LIU ; Tiemei LIU ; Xiaoxin LIU ; Zhiwei LIU ; Zhongdi LIU ; Hua LU ; Jianfeng LUAN ; Jianjun LUO ; Qun LUO ; Dingfeng LYU ; Qi LYU ; Xianping LYU ; Aijun MA ; Liqiang MA ; Shuxuan MA ; Xainjun MA ; Xiaogang MA ; Xiaoli MA ; Guoqing MAO ; Shijie MU ; Shaolin NIE ; Shujuan OUYANG ; Xilin OUYANG ; Chunqiu PAN ; Jian PAN ; Xiaohua PAN ; Lei PENG ; Tao PENG ; Baohua QIAN ; Shu QIAO ; Li QIN ; Ying REN ; Zhaoqi REN ; Ruiming RONG ; Changshan SU ; Mingwei SUN ; Wenwu SUN ; Zhenwei SUN ; Haiping TANG ; Xiaofeng TANG ; Changjiu TANG ; Cuihua TAO ; Zhibin TIAN ; Juan WANG ; Baoyan WANG ; Chunyan WANG ; Gefei WANG ; Haiyan WANG ; Hongjie WANG ; Peng WANG ; Pengli WANG ; Qiushi WANG ; Xiaoning WANG ; Xinhua WANG ; Xuefeng WANG ; Yong WANG ; Yongjun WANG ; Yuanjie WANG ; Zhihua WANG ; Shaojun WEI ; Yaming WEI ; Jianbo WEN ; Jun WEN ; Jiang WU ; Jufeng WU ; Aijun XIA ; Fei XIA ; Rong XIA ; Jue XIE ; Yanchao XING ; Yan XIONG ; Feng XU ; Yongzhu XU ; Yongan XU ; Yonghe YAN ; Beizhan YAN ; Jiang YANG ; Jiangcun YANG ; Jun YANG ; Xinwen YANG ; Yongyi YANG ; Chunyan YAO ; Mingliang YE ; Changlin YIN ; Ming YIN ; Wen YIN ; Lianling YU ; Shuhong YU ; Zebo YU ; Yigang YU ; Anyong YU ; Hong YUAN ; Yi YUAN ; Chan ZHANG ; Jinjun ZHANG ; Jun ZHANG ; Kai ZHANG ; Leibing ZHANG ; Quan ZHANG ; Rongjiang ZHANG ; Sanming ZHANG ; Shengji ZHANG ; Shuo ZHANG ; Wei ZHANG ; Weidong ZHANG ; Xi ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Xiaojun ZHANG ; Guoqing ZHAO ; Jianpeng ZHAO ; Shuming ZHAO ; Beibei ZHENG ; Shangen ZHENG ; Huayou ZHOU ; Jicheng ZHOU ; Lihong ZHOU ; Mou ZHOU ; Xiaoyu ZHOU ; Xuelian ZHOU ; Yuan ZHOU ; Zheng ZHOU ; Zuhuang ZHOU ; Haiyan ZHU ; Peiyuan ZHU ; Changju ZHU ; Lili ZHU ; Zhengguo WANG ; Jianxin JIANG ; Deqing WANG ; Jiongcai LAN ; Quanli WANG ; Yang YU ; Lianyang ZHANG ; Aiqing WEN
Chinese Journal of Trauma 2024;40(10):865-881
Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.
5. Silybin ameliorates lipid metabolism disorders in mice with non-alcoholic steatohepatitis
Zuhuan CAI ; Taomei DENG ; Naijie WEI ; Guangji WANG ; Jingwei ZHANG ; Dan ZHU ; Fei QIAN
Chinese Journal of Clinical Pharmacology and Therapeutics 2023;28(3):241-248
AIM: To investigate the regulatory effects of silybin on hepatic lipid metabolism in mice with non -alcoholic steatohepatitis (NASH) induced by high - fat and high-cholesterol (HFHD) diet. METHODS: Mice were fed a HFHD diet to construct a NASH model, and serum levels of triacylglycerol (TAG), total cholesterol (T-CHO), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured using biochemical kits. H&E staining and oil red O staining were used to detect histopathological changes in the liver. Lipidomics was used to detect the alterations of hepatic lipid metabolism in NASH mice. RESULTS: Silybin significantly inhibited the increase of body weight, liver weight and abdominal fat, decreased serum T-CHO, TAG and LDL-C levels, improved hepatic lipid droplet accumulation and ballooning degeneration, and back-regulated hepatic palmitoleic acid (C16: 1) and polyunsaturated long-chain fatty acids (PUFAs) in NASH mice. CONCLUSION: Silybin possibly reduced hepatic lipid accumulation and lipotoxicity by modulating abnormal hepatic lipid metabolism in mice induced by HFHC diet.
6.Application of case-based learning in the image post-processing teaching of standardized training of medical imaging technology
Xuelin PAN ; Jiayu SUN ; Wei CHENG ; Yuan YUAN ; Hehan TANG ; Liping DENG ; Lingling QIAN
Chinese Journal of Medical Education Research 2023;22(2):284-288
Objective:To explore the application effect of case-based learning (CBL) and lecture-based learning (LBL) in the teaching of image post-processing course in the standardized training system of medical imaging technology.Methods:A total of 34 trainees in the standardized training of imaging technology of Batch 2018 in West China Hospital of Sichuan University were divided into the experimental group and the control group according to their student numbers, with 17 students in each group. CBL teaching was carried out in the experimental group, and LBL teaching was carried out in the control group. According to the standardized training course design, after one year of image post-processing course teaching, the teaching effect was evaluated through closed-book examination, questionnaire survey and post-processing test. SPSS 20.0 was used for t-test and Mann-Whitney U test. Results:The scores of closed-book examinations (74.42±6.10) and post-processing test (73.47±6.03) in the experimental group were higher than those in the control group [(69.11±3.70) and (69.08±6.51)], and the difference was statistically significant ( P<0.05). The questionnaire survey showed that the students in the experimental group recognized CBL teaching in terms of learning interests stimulation, classroom atmosphere mobilization, clinical thinking cultivation, self-study ability training, and analysis of difficult and rare cases, etc. Conclusion:In the image post-processing course of standardized training of medical imaging technology, the rational application of CBL teaching mode is helpful to improve students' learning enthusiasm, self-learning ability, comprehensive analysis of clinical ability, practical ability, innovation consciousness and so on.
7.Study on promotion of the scientific research capability for young imaging technologists by STAR training model in continuing education
Hehan TANG ; Liping DENG ; Xuelin PAN ; Yuan YUAN ; Wei YU ; Lingling QIAN ; Yuming LI
Chinese Journal of Medical Education Research 2023;22(8):1238-1241
Combing with the professional characteristics of imaging technology, Radiological Department of West China Hospital, Sichuan University established the STAR training model for imaging technologists to cultivate the scientific research quality of young technicians, which includes sub-professional group training, tutor responsibility system, arrangement of research time, and reading-film session of technologists. Practice shows that this training model has made a series of achievements so far, such as that the number of publishing articles, funds application, authorized patents and oral presentation at international congress has been significantly increased. In addition, there is a high recognition of the STAR training model among young imaging technologists. Therefore, the STAR model can stimulate the scientific research passion of young technologists, and improve their scientific research capability.
8.Research progress in clinical application and pharmacological effect of Yiyi Fuzi Baijiang Powder.
Liu-Yi WEI ; Er-Wei HAO ; Xiao-Tao HOU ; Liu-Zhi WEI ; Zhe QIN ; Xiao YANG ; Qian XIAO ; Shi-du YAN ; Jia-Gang DENG
China Journal of Chinese Materia Medica 2023;48(18):4893-4901
Yiyi Fuzi Baijiang Powder(YFBP), originating from Synopsis of the Golden Chamber, is a classic prescription composed of Coicis Semen, Aconiti Lateralis Radix Praeparata, and Patriniae Herba for the treatment of abscesses and pus discharge. This article presented a systematic analysis of the clinical application of YFBP, including the indicated diseases, the number of cases, efficacy, dosage, administration methods, and compatibility with other drugs. The analysis reveals that YFBP has a wide range of clinical applications. It is commonly used, often with modifications or in combination with western medicine, for diseases in the fields of gastroente-rology, gynecology, urology, dermatology, and others. And most of the Traditional Chinese Medicine(TCM) evidence involved in these diseases are damp-heat evudence. The prescription shows rich variations in clinical administration methods, and most of which are the treatment of aqueous decoction of it. The therapeutic effect is also significant, and the total effective rate of clinical treatment is re-latively high. Additionally, this article summarized the pharmacological research on YFBP and found that it possessed various pharmacological effects, including anti-inflammatory, antioxidant, anticancer, and immune-modulating properties. Finally, correlation analysis was conducted on the main diseases, TCM types, prescription doses, pharmacological effects and action targets of YFBP, which to show the relationship between these five aspects in a visual form, reflecting the relationship between its clinical application and modern pharmacological effects. These findings provide a reference basis for further development and research on YFBP.
Powders
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Drugs, Chinese Herbal/pharmacology*
;
Medicine, Chinese Traditional
;
Diterpenes
;
Aconitum
9.Preparation of berberine-naringin dual drug-loaded composite microspheres and evaluation of their antibacterial-osteogenic properties.
Wei XIONG ; Lingmei YUAN ; Liangxia WANG ; Guowen QIAN ; Chaoyi LIANG ; Bin PAN ; Ling GUO ; Wenqiang WEI ; Xunxiang QIU ; Wenfang DENG ; Zhikui ZENG
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(12):1505-1513
OBJECTIVE:
To develop a drug-loaded composite microsphere that can simultaneously release the berberine (BBR) and naringin (NG) to repair infectious bone defects.
METHODS:
The NG was loaded on mesoporous microspheres (MBG) to obtain the drug-loaded microspheres (NG-MBG). Then the dual drug-loaded compound microspheres (NG-MBG@PDA-BBR) were obtained by wrapping NG-MBG with polydopamine (PDA) and modifying the coated PDA with BBR. The composite microspheres were characterized by scanning electron microscopy, X-ray diffraction, specific surface area and pore volume analyzer, and Fourier transform infrared spectroscopy; the drug loading rate and release of NG and BBR were measured; the colony number was counted and the bacterial inhibition rate was calculated after co-culture with Staphylococcus aureus and Escherichia coli for 12 hours to observe the antibacterial effect; the biocompatibility was evaluated by live/dead cell fluorescence staining and cell counting kit 8 assay after co-culture with rat's BMSCs for 24 and 72 hours, respectively, and the osteogenic property was evaluated by alkaline phosphatase (ALP) staining and alizarin red staining after 7 and 14 days, respectively.
RESULTS:
NG-MBG@PDA-BBR and three control microspheres (MBG, MBG@PDA, and NG-MBG@PDA) were successfully constructed. Scanning electron microscopy showed that NG-MBG@PDA-BBR had a rough lamellar structure, while MBG had a smooth surface, and MBG@PDA and NG-MBG@PDA had a wrapped agglomeration structure. Specific surface area analysis showed that MBG had a mesoporous structure and had drug-loading potential. Low angle X-ray diffraction showed that NG was successfully loaded on MBG. The X-ray diffraction pattern contrast showed that all groups of microspheres were amorphous. Fourier transform infrared spectroscopy showed that NG and BBR peaks existed in NG-MBG@PDA-BBR. NG-MBG@PDA-BBR had good sustained drug release ability, and NG and BBR had early burst release and late sustained release. NG-MBG@PDA-BBR could inhibit the growth of Staphylococcus aureus and Escherichia coli, and the antibacterial ability was significantly higher than that of MBG, MBG@PDA, and NG-MBG@PDA ( P<0.05). But there was a significant difference in biocompatibility at 72 hours among microspheres ( P<0.05). ALP and alizarin red staining showed that the ALP positive area and the number of calcium nodules in NG-MBG@PDA-BBR were significantly higher than those of MBG and NG-MBG ( P<0.05), and there was no significant difference between NG-MBG@PDA and NG-MBG@PDA ( P>0.05).
CONCLUSION
NG-MBG@PDA-BBR have sustained release effects on NG and BBR, indicating that it has ideal dual performance of osteogenesis and antibacterial property.
Rats
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Animals
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Osteogenesis
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Delayed-Action Preparations/pharmacology*
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Microspheres
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Berberine/pharmacology*
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Anti-Bacterial Agents/pharmacology*
;
Escherichia coli
10.CHESS endoscopic ruler in objective measurement of diameter of esophageal varices in liver cirrhosis and portal hypertension: a prospective multicenter study
Shengjuan HU ; Jianping HU ; Shaoqi YANG ; Xiaoguo LI ; Yanhong DENG ; Ruichun SHI ; Xiaoqin LI ; Hailong QI ; Qian SHEN ; Fang HE ; Jun ZHU ; Bin MA ; Xiaobing YU ; Jianyang GUO ; Yuehua YU ; Haijiang YONG ; Wentun YAO ; Ting YE ; Hua WANG ; Wenfu DONG ; Jianguo LIU ; Qiang WEI ; Jing TIAN ; Haoxiang HE ; Changhui HE ; Yifei HUANG ; Yang BU ; Xiaolong QI
Chinese Journal of Digestion 2023;43(3):193-198
Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.

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